| Background and purpose:Research shows that microRNA(miRNA)is abnormally expressed in cancer and participate in the pathogenesis of cancer.As a biomarker,microRNA can play an important role in the diagnosis and prognosis of some tumors.Some researchers have also demonstrated the correlation between miRNA and the diagnosis and prognosis of hepatoblastoma,but most of the studies are small in sample size and single in research method,which has certain limitations.In order to enhance the reliability of the research results,this paper summarizes the current research articles on the clinical value of miRNAs in children's hepatoblastoma(HB),and makes a meta-analysis to evaluate the diagnostic and prognostic value of miRNAs in children's hepatoblastoma,in order to improve the diagnostic rate and evaluate the prognosis of hepatoblastoma.Method:According to the guideline of the observational study meta-analysis(moose)of the epidemiology group,the online database was searched extensively and sensitively,and the clinical studies related to the diagnosis and prognosis of hepatoblastoma were retrieved.Then strictly according to the established inclusion and exclusion criteria for literature screening and summary,data extraction,and finally included in the research for statistical analysis.In this study,we used the combined parameters including sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,area under curve(AUC)and diagnostic ratio(DOR)to determine the overall diagnostic efficacy.The effect of miRNAs on overall survival rate(OS)and event free survival rate(EFS)of patients with hepatoblastoma was used as prognostic indicators.The combined risk ratio(HR)and 95%confidence interval(CI)showed the correlation between them.Subgroup and sensitivity analysis were performed only in the presence of heterogeneity.Finally,20 studies including 10 diagnostic studies and 10 prognostic studies met the inclusion criteria of this meta-analysis.Results:Through a systematic review of previous studies on the diagnostic and prognostic value of different miRNAs in hepatoblastoma,we found that abnormal expression of miRNAs has certain diagnostic efficacy and prognostic effect on children's hepatoblastoma.The diagnostic meta-analysis included 10 studies,447 patients and 309 healthy controls.We observed the abnormal expression of miR-21,miR-17,miR-146a,mir-302d,mir-19b,mir-492,miR-34a,mir-34b and mir-34c,which can be used to distinguish hepatoblastoma patients and healthy controls.Ten studies were combined for statistical analysis.The combined sensitivity was 0.76(95%CI:0.72-0.80),the combined specificity was 0.75(95%CI:070-0.80),the positive likelihood ratio was 2.79(95%CI:2.12-3.66),the negative likelihood ratio was 0.34(95%CI:0.26-0.45),the diagnostic ratio was 10.24(95%CI:6.55-16.00),and the area under the curve AUC=0.8278.The prognosis meta-analysis was finally included in 10 studies,a total of 409 patients.We found that the increased expression of miR-21,mir-492,miR-222 and mir-224 indicated a poor prognosis of hepatoblastoma,while the decreased expression of mir-193a,miR-34a,mir-34b and mir-34c indicated a poor prognosis.Meta analysis of 10 prognostic studies was carried out.The combined hr of overall survival rate(OS)was 1.74(95%CI:1.20-2,29)and that of event-free survival rate(EFS)was 1.74(95%CI:1.31-2.18)when Stata was used to calculate HR and 95%CI,indicating that OS and EFS of hepatoblastoma patients with abnormal expression of miRNAs would be reduced.Conclusion:Through systematic review and meta-analysis,it is concluded that there are many kinds of abnormal expression of miRNAs in children's hepatoblastoma.These abnormal expression of miRNAs can be used as biomarkers to provide basis for the diagnosis and prognosis of children's hepatoblastoma,and provide possibility for the targeted treatment of children's hepatoblastoma in the future. |
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